Childhood obesity is associated with negative physical and psychosocial outcomes, especially for children from low-income backgrounds. It is critical to adapt evidence-based family healthy weight programs to meet the needs of this population. The Framework for Reporting Adaptations and Modifications to Evidence-Based Interventions was used to describe the process of using qualitative data from community and intervention stakeholders, children with overweight or obesity from low-income backgrounds, and caregivers to guide adaptations to the JOIN for ME pediatric weight management intervention. Qualitative interviews were conducted with key community and intervention stakeholders (e.g., nurse care managers, prior JOIN for ME coaches; N = 21). Focus groups were conducted in both Spanish and English with children with overweight or obesity from low-income backgrounds (N = 35) and caregivers of children with overweight or obesity from low-income backgrounds (N = 71). Qualitative data analysis informed modifications including content adaptations to simplify and tailor materials, contextual adaptations to improve intervention engagement and framing, resource awareness, and modality of delivery, training adaptations, and implementation/scale-up activities to increase connections with community partners. The process of engaging multiple stakeholder perspectives to tailor an existing intervention can provide a model for future researchers to improve the potential disseminability of an intervention.
Keywords: Dissemination; Implementation; Intervention adaptations; Pediatric obesity; Pediatric weight management.
Obesity during childhood is related to a number of negative outcomes for youth, with children from low-income backgrounds at especially high risk for obesity and related negative outcomes. There is a pressing need for programs to address weight in children and families that meet the needs of families from low-income backgrounds. This study outlines adaptations made to an evidence-based family healthy weight program to increase the likelihood of dissemination in low-income communities. Interviews were conducted with community stakeholders, children with overweight or obesity from low-income backgrounds, and caregivers of children with overweight or obesity from low-income backgrounds. These interviews led to simplification and tailoring of curriculum materials, changes to framing of weight management, increased information about available resources, remote intervention delivery, and changes to scale-up activities.
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